Evidence that incidental Lewy body disease is pre-symptomatic Parkinson's disease

Dennis W. Dickson, Hiroshige Fujishiro, Anthony DelleDonne, Joshua Menke, Zeshan Ahmed, Kevin J. Klos, Keith A. Josephs, Roberta Frigerio, Melinda Burnett, Joseph R. Parisi, J. Eric Ahlskog

Research output: Contribution to journalArticlepeer-review

257 Scopus citations


Lewy bodies, the histologic hallmark of Parkinson's disease (PD), are detected in the brains of about 10% of clinically normal people over the age of 60 years. When Lewy bodies are found in normal individuals, the process is sometimes referred to as incidental Lewy body disease (iLBD). The distribution of Lewy bodies in iLBD is similar to the distribution in PD, but neuronal populations vulnerable to Lewy bodies do not show significant neuronal loss in iLBD. It remains unknown if Lewy bodies in this setting represent pre-symptomatic PD or an age-related change unrelated to PD. To address this question we identified cases of iLBD and used a marker for dopaminergic and noradrenergic neurons, tyrosine hydroxylase (TH), to determine if there were changes similar to those found in PD. TH immunoreactivity in the striatum and the epicardial nerve fibers was decreased in iLBD compared to normal controls, but not to the same extent as in PD. The findings suggest that iLBD is preclinical PD and that the lack of symptoms is due to subthreshold pathology.

Original languageEnglish (US)
Pages (from-to)437-444
Number of pages8
JournalActa neuropathologica
Issue number4
StatePublished - Apr 2008


  • Heart
  • Immunohistochemistry
  • Incidental Lewy bodies
  • Parkinson's disease
  • Striatum
  • Tyrosine hydroxylase

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Clinical Neurology
  • Cellular and Molecular Neuroscience


Dive into the research topics of 'Evidence that incidental Lewy body disease is pre-symptomatic Parkinson's disease'. Together they form a unique fingerprint.

Cite this